by Dr Justin Marley

Detailed Report on Dementia in Australia Published News Roundup: October 2012 4th Edition

A new report ‘Dementia in Australia‘ has been published under a Creative Commons License 3.0. The report is very detailed and provides information and discussion which is relevant to other countries also. The authors of the report predict that within the next 40 years the prevalence of Dementia will have increased three-fold.

‘An estimated 298,000 Australians had dementia in 2011, of whom 62% were women, 74% were aged 75 and over, and 70% lived in the community. Dementia poses a substantial challenge to health, aged care and social policy. Based on projections of population ageing and growth, the number of people with dementia will reach almost 400,000 by 2020. Although projection methods vary, the number of people with dementia is projected to triple between 2011 and 2050, to reach around 900,000 by 2050. Dementia is a leading cause of death, accounting for 6% of all deaths in 2010. Total direct health and aged care services expenditure on people with dementia was at least $4.9 billion in 2009–10‘

They further report that

‘People with dementia aged 65 and over had a substantially higher average number of health conditions than all people in this age group (5.4 and 2.9 respectively).• The majority (88%) of people with dementia in private dwellings lived with others; men (93%) were more likely than women (84%) to do so.• Among people living in the community, those with dementia were most likely to need help with health care (84%), mobility (80%) and private transport (80%). For those in cared accommodation, 99% required help with health care, 98% with self-care activities, and 91% with cognitive or emotional tasks.• Three-quarters (75%) of people with dementia made use of a combination of formal and informal assistance to obtain help in the areas for which they needed assistance, while 22% relied solely on informal assistance.• Among permanent residents in residential aged care, those with dementia were more likely than those without dementia to need high care (87% versus 63%), and to have higher care needs in relation to activities of daily living and behaviour, but not in relation to complex health care. The majority of residents with dementia had a diagnosis of Alzheimer disease, with the proportion higher in women (79%) than men (67%)‘

The report also includes other types of demographic data that help to build up a profile of people with Dementia.

There were many other pieces of useful clinical information including comorbid health conditions.

Hospitalisation figures were identified by age and graphed.

Hospitalisations were analysed according to Dementia subtype.

When Dementia was not the primary diagnosis but was present the principal diagnosis for hospitalisation was analysed as below

The authors found that there had been a decrease in the number of days that people with Dementia remained in hospital in 2009-2010 compared to 2004-2005

‘The average stay for hospitalisations with dementia as the principal diagnosis decreased from 25 days in 2004–05 to 18 days in 2009–10‘

The prescription data for medication for Dementia was also analysed

The authors of the report also looked at the needs of people with Dementia when they were provided with care packages. There are three types of care packages described in the table below with increasing levels of support – Community Aged Care Packages (CACPs), Extended Aged Care at Home (EACH) and Extended Aged Care at Home Dementia (EACHD).

The estimated economic costs of Dementia care were also analysed

There is a PLOS One study (n=59) which looks at male DNA in female brains post-mortem and produced some curious results. The researchers found evidence of male DNA in the brains. There were 26 women without neurological disease and 33 women with Alzheimer’s Disease. The researchers used a marker for the gene DYS14 and in one case examined for male cells (which were found). The researchers found evidence of male DNA in many of the brains. They hypothesised that this originated from male foetuses and found evidence to support this hypothesis with a secondary analysis. The researchers found a reduced prevalence and concentration of male DNA in the brains of people who had received a diagnosis of Alzheimer’s Disease. These are interesting findings and it will be useful to see the results of further replication studies.

In a study published in the Proceedings of the National Academy of Sciences, one research group looked at the facial recognition area in the Fusiform Gyrus. They found that this area didn’t just respond to faces but also automobiles. The study supports the hypothesis that this region is not specialised for faces alone.

Evolutionary Psychiatry

A transfer of technology from one area to another has been suggested for analysing human remains and may have an application in understanding the evolution of walking. The software is used in geological analysis and helps researchers to understand if features of a landscape are clustered non-randomly in an area. The proposal suggests that this software can be used to examine the internal structure of bone and to make inferences about the way that bone has developed and the stresses that have been applied to the bone. This is interesting for another reason as there have been other proposals for transferring geographical information system technology to the medical domain. The video below illustrates the potential for application of this technology in public health.

Suggest for Potential Application of Open Source Geographical Information Systems to Public Health

Index: There are indices for the TAWOP site here and hereTwitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link. Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period. TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link. Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk. Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

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